Table 5.

Factors that influence the scaling up of post pregnancy family planning

Category	Factor	Reference
People	Family involvement, accompaniment, and tradition	[38]
	Fear of judgment	[38]
	Lack of interest	[45]
	Knowledge regarding lactational amenorrhea and suitable contraceptive methods	[50]
	Loyalty toward the religious doctrines in religious based hospitals in post abortion contraceptive counselling instead of applying national family planning guidelines	[36]
	Male partner:
	Integration of men	[45]
	Partner sharing in decision making	[47]
	Myths and misinformation, Misconceptions about modern contraception	[38, 50]
	Perceived quality of facility services	[38]
	Factors related to postnatal care
	Prioritization by women of scheduled postpartum visits	[50]
	Opportunities to encourage continuity of care, especially for PPFP	[38]
	A contraception-dedicated six-week postpartum	[50]
	Religious and traditional norms:
	Sexual abstinence for up to three to six months postpartum	[50]
	Social pressure to closely space pregnancies	[38]
	Traditional views on the consequences borne by closely spaced children and their mothers	[50]
	Cultural and religious objections to family planning and lingering misconceptions	[48]
Service delivery	Access to facility services	[38]
	Factors related to counselling
	dedicated PPFP counseling materials	[50]
	privacy within the health facility	[53]
	time necessary to fully counsel women on all available and appropriate methods	[45]
	Time required for One-to-one counseling	[55]
	Limited availability of clinic days and scheduled visits dedicated to contraception	[50]
	Extent of antenatal care (ANC) coverage	[48]
Medical products	Available equipment and supplies	[48]
	Availability of readily accessible methods and plans for stock-outs in health facilities	[50]
Financing	Challenges with Engaging private insurance companies	[27]
	Financial risk intolerance	[30]
	LARC device cost/reimbursement	[27, 30]
	Administrative infrastructure and financial flexibility	[30]
	Out-of-pocket payment of contraceptives	[50]
	Cost/Fund to buy or to purchase the instruments or LARC by health facilities	[27, 49]
Health information systems	Challenges in acquiring data use agreements between public health and medicaid	[27]
	Difficulty analyzing raw medicaid claims data	[27]
	Long duration for resolving technical billing issues	[27]
	Technical complexity of information technology system for claims processing	[27]
	Pre-existing strong collaborations across agencies with respect to data	[27]
Leadership and Governance	Leadership stability	[30]
	Support from high-level leadership	[27]
	Clinical champions	[27, 30]
	Co-location of health department and financial agency and/or strong pre-existing working relationship between agencies	[27]
	Connecting with rural birthing facilities	[27]
	Translating what works across various contexts	[27]
	Effect of political sensitivity around contraception on team’s ability to work on increasing LARC access	[27]
	Political commitment to post abortion and postpartum FP programs	[49, 50]
	Process changes for coders and pharmacy staff members	[27]
Health workforce	Ability to work with other teams in the learning community and share resources	[27]
	Continued support and guidance from trainers in informal follow-up visits and phone calls	[48]
	Judgmental treatment from health providers	[38]
	Inability to perform the procedure or Lack of knowledge/skills about all contraceptive methods	[45, 48]
	Lack of live clinical insertions	[45]
	Lack of supervision throughout practice insertion sessions	[45]
	Pre-existing personal connections of team members	[27]
	Shared culture and language facilitated the training, reduced miscommunication between teams, and built engagement and mutual support	[48]
	Spill over: hearing about process from others in the learning community	[27]
	Team members long and continuous involvement with immediate postpartum LARC initiative	[27]
	Turnover in team members	[27]
	Uncertainty about goal for immediate postpartum contraceptive use	[27]